Her liver enzymes spiked to 100 times above normal
As the wet season tightens its hold on Ho Chi Minh City, two ancient adversaries — hand, foot and mouth disease and dengue fever — have returned with uncommon force, their case counts surging 164 and 71 percent respectively above last year's toll. Five children have died from HFMD and one person from dengue, while intensive care wards fill with the most vulnerable. Public health authorities are responding with expanded training, hospital reinforcement, and a proposed multi-year immunization program, even as they acknowledge the peak may still lie ahead.
- By mid-April, Ho Chi Minh City had recorded over 12,000 HFMD cases and nearly 14,000 dengue cases — numbers that had already climbed past 15,000 and 16,000 respectively by early May, with no clear ceiling in sight.
- Five children have died from HFMD and one person from dengue, while severe cases — including a 10-year-old girl whose dengue triggered multi-organ failure and a rare, life-threatening immune cascade — are pushing children's hospitals to their limits.
- Specific communes and wards are bearing disproportionate burdens, revealing geographic fault lines of vulnerability that complicate a city-wide response.
- Doctors are racing to build clinical capacity at smaller facilities, while specialists warn that rare but catastrophic dengue complications like haemophagocytic syndrome can kill without rapid, expert intervention.
- Health authorities insist the overall situation remains manageable, yet their own proposal for a three-year expanded immunization program signals that the threat is being taken seriously beyond the immediate crisis.
Ho Chi Minh City is contending with a sharp and simultaneous rise in two infectious diseases. From January through mid-April, the city recorded 12,063 cases of hand, foot and mouth disease — a 164 percent increase over the same period last year — including five deaths. April alone accounted for more than 5,000 of those cases. Dengue fever has followed a parallel trajectory, with 13,738 confirmed cases through mid-April, up 71 percent year-on-year, and one death. By early May, both totals had surpassed 15,000. Certain communes and urban wards are carrying the heaviest per-capita burdens, pointing to concentrated pockets of risk within the broader surge.
The human cost is most visible in the city's children's hospitals, where intensive care units are receiving patients with severe and complex presentations. Professor Phạm Văn Quang of Children's Hospital 1 described a 10-year-old girl transferred from Đồng Tháp Province after five days of high fever, vomiting, and abdominal pain. She arrived in dengue shock syndrome, with liver enzymes one hundred times above normal. Her condition worsened after transfer — lung function declined, blood pressure destabilized, and liver damage deepened. The medical team administered oxygen, albumin, blood products, and clotting support, yet her fever held. Further testing uncovered haemophagocytic syndrome, a rare inflammatory condition in which the immune system turns destructive. Her ferritin levels had reached nearly 50,000 micrograms per liter. After specialists initiated anti-inflammatory treatment, her fever broke within a day and her organs recovered within a week. She was expected to go home.
Quang stressed that haemophagocytic syndrome linked to dengue, though uncommon, is fatal without swift recognition and treatment. He urged parents not to wait if a child's fever persists beyond two or three days during dengue season, particularly alongside abdominal pain, persistent vomiting, or any bleeding signs.
The municipal health department has responded by ordering clinical training across facilities, directing larger hospitals to support smaller ones, and submitting a proposal for an expanded immunization program spanning 2026 to 2028. Officials describe the overall situation as under control, but the unbroken upward curve of cases in recent weeks suggests the hardest stretch may still be ahead.
Ho Chi Minh City is in the grip of a disease surge that has caught the attention of public health officials and hospital administrators alike. From January through mid-April this year, the city documented 12,063 cases of hand, foot and mouth disease—a staggering 164 percent jump compared to the same period last year—and five people died from the infection. By early May, that number had climbed to over 15,000 cases. The spike was most severe in April alone, when doctors saw 5,243 patients with the disease, nearly double the previous month's count.
Dengue fever has been equally relentless. Through mid-April, the city recorded 13,738 dengue cases, representing a 71 percent increase year-over-year. By May 3, confirmed infections had reached nearly 16,000. One person has died from dengue so far this year. The geographic pattern of both diseases reveals pockets of vulnerability: Côn Đảo Special Zone, Bình Khánh Commune, and Long Điền Commune have reported the highest rates of hand, foot and mouth disease per capita, while dengue has concentrated in An Nhơn Tây Commune and two wards in the western part of the city.
The health department has also documented 168 measles cases, 18 COVID-19 infections, and a single case of Mpox, though none of these have resulted in deaths. Officials have characterized the overall disease situation as manageable, with no major outbreaks of particularly dangerous pathogens reported, yet the sheer volume of cases is straining hospital resources and forcing a recalibration of public health strategy.
The human toll becomes visible in the intensive care units of the city's children's hospitals. Professor Phạm Văn Quang, who leads the Intensive Care and Poison Control Department at Children's Hospital 1, has witnessed a troubling pattern: severe dengue cases arriving with multi-organ failure and life-threatening complications. One case illustrates the stakes. A 10-year-old girl from Đồng Tháp Province came to a local hospital after five days of high fever, vomiting, and abdominal pain. By the fifth day of illness, she was diagnosed with dengue shock syndrome. Her liver enzymes spiked to 100 times above normal levels. When she was transferred to Children's Hospital 1, her condition deteriorated further—her lungs began to fail, her blood pressure became unstable, and her liver damage worsened.
The medical team moved quickly. They provided oxygen support, administered albumin to counteract shock, transfused blood products, and worked to stabilize her clotting function. Yet her fever persisted at dangerous levels. Additional testing revealed something rarer and more sinister: haemophagocytic syndrome, a severe inflammatory condition triggered by the dengue infection. Her ferritin levels—a marker of inflammation—had climbed to nearly 50,000 micrograms per liter, indicating an immune system in overdrive. After consultation between intensive care and blood specialists, doctors began anti-inflammatory treatment. Within 24 hours, her fever broke. Within a week, her liver, kidneys, and blood clotting functions had normalized. She regained consciousness, began eating normally, and was expected to go home soon.
Quang emphasized that while haemophagocytic syndrome associated with dengue is uncommon, it is catastrophically dangerous. Without rapid treatment, it can destroy the liver and kidneys, trigger fatal bleeding, and kill the patient. He urged parents to seek medical care immediately if their children develop fever lasting two or three days during dengue season, especially if accompanied by abdominal pain, relentless vomiting, or any signs of bleeding.
In response to the surge, the municipal Department of Health has ordered training programs for medical facilities across the city to strengthen clinical capacity and infection control. Upper-level hospitals have been directed to provide technical support to smaller facilities. The department has also submitted a proposal to city leadership requesting approval for an expanded immunization program covering 2026 through 2028. Health officials say they will continue monitoring disease trends and implementing preventive measures, though the trajectory of cases in recent weeks suggests the peak may not yet have arrived.
Citações Notáveis
Haemophagocytic syndrome linked to dengue fever is rare, but it is highly dangerous and can lead to liver failure, kidney failure, coagulation disorders and death if not treated promptly.— Professor Phạm Văn Quang, head of Intensive Care and Poison Control Department, Children's Hospital 1
Parents should bring children to medical facilities early if they develop fever lasting two to three days accompanied by abdominal pain, persistent vomiting or bleeding symptoms during dengue season.— Professor Phạm Văn Quang
A Conversa do Hearth Outra perspectiva sobre a história
Why is hand, foot and mouth disease spiking so dramatically in Ho Chi Minh City right now?
The source doesn't explain the underlying cause—whether it's seasonal, environmental, or related to population immunity. What we know is that April saw a particularly sharp jump, suggesting something shifted in transmission patterns that month. The disease is most common in young children, and the city's density and warm climate create ideal conditions for spread.
The dengue numbers are also climbing fast. Are these two diseases connected, or is the city just facing multiple problems at once?
They're separate pathogens with different transmission routes—hand, foot and mouth spreads through contact and respiratory droplets, while dengue travels through mosquitoes. But they're both surging simultaneously, which suggests the city's public health infrastructure may be stretched thin across multiple fronts. That's a different kind of pressure than a single outbreak.
The case of the 10-year-old girl sounds terrifying. How common is that kind of severe dengue?
The doctor made clear that haemophagocytic syndrome linked to dengue is rare. But the fact that Children's Hospital 1 has admitted several severe dengue shock cases recently suggests the hospital is seeing a higher proportion of dangerous cases than usual. It's not that every dengue patient becomes that sick—it's that more people are getting dengue, so more severe cases appear in absolute numbers.
What does it mean that her liver enzymes were 100 times normal?
It means her liver was being severely damaged by the infection and the body's inflammatory response to it. The organ was essentially failing. That's why the doctors had to be so aggressive with treatment—they were trying to keep her alive long enough for her immune system to regain control.
The health department says the situation is under control. Do you believe that?
They're being technically accurate—there's no single catastrophic outbreak of a single disease. But 15,000 cases of hand, foot and mouth disease and 16,000 dengue cases in four months is a lot of sick people. "Under control" might mean they're not overwhelmed yet, but the trajectory is concerning enough that they're already planning expanded vaccination programs through 2028.